Objective: To investigate low-frequency fluctuation amplitude changes in resting-state brain fMRI and its correlation with clinical hearing levels in patients with clinical hearing level in patients with unilateral hearing impairment. Methods: Forty-five patients with unilateral hearing impairment[12 males and 33 females, aged 36-67 (46.0±9.7) years], and 31 controls with normal hearing[9 males and 22 females, aged 36-67 (46.0±10.1) years], were retrospectively included. All subjects underwent blood oxygen level-dependent (BOLD) resting-state functional magnetic resonance imaging and high-resolution T1-weighted imaging. The patients were divided into the left-sided hearing impaired group(24 cases), and the right-sided hearing impaired group(21 cases). After data being preprocessed, differences in low frequency amplitude (ALFF) metrics between the evaluated patients and controls were calculated and analyzed, and the statistics were corrected for Gaussian random field (GFR). Results: Overall comparative analysis of patients with hearing impairment showed that one-way ANOVA among the three groups showed abnormal ALFF values only in the right anterior cuneiform lobe (GRF adjusted P=0.002). The ALFF value of the hearing impaired group was higher than that of the control group in one cluster (peak coordinates: X=9, Y=-72, Z=48, T=5.82), involving the left occipital gyrus, right anterior cuneiform lobe, left superior cuneiform lobe, left superior parietal gyrus, and left angular gyrus (GRF adjusted P=0.031). The ALFF value of the hearing impaired group was lower than that of the control group in three clusters (peak coordinates: X=57, Y=-48, Z=-24; T=-4.99; X=45, Y=-66, Z=0, T=-4.06; X=42, Y=-12, Z=36, T=-4.03), involving the right inferior temporal gyrus, the right middle temporal gyrus, and the right precentral gyrus (GRF adjusted P=0.009). Compared with the control group, the ALFF value of the left hearing impairment group was significantly higher than that of the control group in one cluster (peak coordinates: X=-12, Y=-75, Z=45, T=5.78), involving the left anterior cuneiform lobe, right anterior cuneiform lobe, left middle occipital gyrus, left superior parietal gyrus, left superior occipital gyrus, left cuneiform lobe, and right cuneiform lobe (P=0.023 after GRF correction). Compared with the control group, the right hearing impairment group had a significantly higher ALFF value in one cluster (peak coordinates: X=9, Y=-46, Z=22, T=6.06), involving the left middle occipital gyrus, right anterior cuneiform lobe, left cuneiform lobe, right cuneiform lobe, left superior occipital gyrus, and right superior occipital gyrus (GRF adjusted P=0.022); The brain area with reduced ALFF values is located in the right inferior temporal gyrus (GRF adjusted P=0.029). Spearman's two-tailed correlation analysis between ALFF values and pure tone average in the abnormal brain regions showed that ALFF values in the abnormal brain regions correlated to some extent with the pure tone average (PTA) only in the left-sided hearing impaired group(PTA=2 000 Hz, r=0.318,P=0.033;PTA=4 000 Hz,r=0.386,P=0.009). Conclusion: The abnormal neural activity within the brain are different in patients with left-sided and right-sided hearing impairment, and the severity of hearing impairment is related to the difference in functional integration of brain regions.
目的： 探讨单侧听力障碍患者静息态脑功能磁共振低频波动振幅（ALFF）差异及其与临床听力的相关性。 方法： 回顾性纳入2020年10月至2022年10月在首都医科大学附属复兴医院就诊的45例单侧听力障碍患者［男12例，女33例，年龄37~67（46.0±9.7）岁］和31名听力正常的对照者［男9名，女22名，年龄36~67（46.0±10.1）岁］。所有受试者均接受血氧水平依赖（BOLD）静息状态功能磁共振成像和高分辨率T1加权成像检查。将患者分为左侧听力障碍组（24例）和右侧听力障碍组（21例）。数据预处理后，计算和分析评估患者和对照者之间ALFF指标的差异，并对统计结果进行高斯随机场（GFR）校正。 结果： 听力障碍患者总体比较分析，三组间单因素方差分析显示仅在右侧楔前叶出现ALFF值异常（GRF校正后P=0.002）；听力障碍组ALFF值高于对照组有1个团簇（峰值坐标为：X=9、Y=-72、Z=48，T=5.82），涉及左侧枕中回、右侧楔前叶、左侧楔叶、左侧枕上回、右侧楔叶、左侧楔前叶、左侧顶上回、左侧角回（GRF校正后P=0.031）；听力障碍组ALFF值低于对照组有3个团簇（峰值坐标分别为：X=57、Y=-48、Z=-24，T=-4.99；X=45、Y=-66、Z=0，T=-4.06；X=42、Y=-12、Z=36，T=-4.03），涉及右侧颞下回、右侧颞中回及右侧中央前回（GRF校正后P=0.009）。左侧听力障碍组与对照组相比，ALFF值高于对照组有1个团簇（峰值坐标为：X=-12、Y=-75、Z=45，T=5.78），涉及左侧楔前叶、右侧楔前叶、左侧枕中回、左侧顶上回、左侧枕上回、左侧楔叶及右侧楔叶（GRF校正后P=0.023）。右侧听力障碍组与对照组相比，ALFF值高于对照组有1个团簇（峰值坐标为：X=9、Y=-46、Z=22，T=6.06），涉及左侧枕中回、右侧楔前叶、左侧楔叶、右侧楔叶、左侧枕上回、右侧枕上回（GRF校正后P<0.022）；ALFF值降低的脑区位于右侧颞下回（GRF校正后P=0.029）。异常脑区ALFF值与纯音平均值（PTA）的Spearman双尾相关分析显示，仅在左侧听力障碍组中异常脑区的ALFF值与PTA具有相关性（PTA=2 000 Hz，r=0.318，P=0.033；PTA=4 000 Hz，r=0.386，P=0.009）。 结论： 左侧与右侧听力障碍患者的大脑内部活动发生异常，且听力受损的严重程度与脑区功能整合的差异有关。.